AASM News Archive

Hypnogram: Preauthorization concerns

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American Academy of Sleep MedicineThursday, July 11, 2013

Recently the AASM requested that members complete a preauthorization survey to help us gather data from your experience with utilization management review and preauthorization for diagnostic sleep testing.

I am grateful to all of the members who took the time to complete this survey. It is important for us to have objective data and documentation that we can share with insurers. In the following weeks we will be compiling and analyzing the data from the survey. The results will be reviewed and discussed by the Board of Directors at our upcoming meeting at the end of this month.

In the meantime, the AASM continues to communicate with payers to discuss your concerns regarding requirements for coverage. Most recently, the AASM has been in contact with Cigna and its utilization management company, CareCentrix. Both companies have been extremely responsive to our inquiries and have provided helpful information for clarification. A summary of their responses to concerns about preauthorization and appeals is available on the AASM website.

I am cognizant that your professional time is valuable; most of us prefer investing our time in providing patient care rather than wasting it chasing paperwork. The AASM will work tirelessly to streamline and simplify pre-authorization processes to ensure timely delivery of care to our patients. The AASM will continue to work with insurers to address any systemic problems related to insurance coverage and reimbursement for sleep medicine services. I will keep you informed of any developments.